Background: General anaesthesia with endotracheal intubation often results in postoperative sore throat, cough and hoarseness of voice. Benzydamine hydrochloride is a topical NSAID with analgesic, local anaesthetic, anti-inflammatory properties. We studied the effect of benzydamine hydrochloride gargling on the incidence and severity of sore throat, cough and hoarseness of voice in patients undergoing elective middle ear surgery under general anaesthesia with endotracheal intubation. Methods: A prospective randomized placebo controlled double blind study, After institutional ethical committee approval, written informed consent was taken from all the patients after explaining the procedure. 120 patients of either gender scheduled for elective middle ear surgeries under general anaesthesia with endotracheal intubation, who fulfilled the inclusion and exclusion criteria were included. Patients were randomized into two groups - Benzydamine hydrochloride group and control group using sealed envelope method. Patients in Benzydamine hydrochloride group were gargled 0.15% of 20ml benzydamine hydrochloride solution and control group patients gargled 20ml of 0.9% saline for 30secs, 5mins before intubation. Conclusion: Preoperative benzydamine hydrochloride oral gargle reduces the incidence and severity of sore throat, cough and hoarseness in patients who underwent elective middle ear surgery under general anaesthesia with endotracheal intubation